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AF in Chronic Aortic Regurgitation Tied to Mortality Risk
AF in Chronic Aortic Regurgitation Tied to Mortality Risk

Medscape

time4 hours ago

  • Health
  • Medscape

AF in Chronic Aortic Regurgitation Tied to Mortality Risk

TOPLINE: Atrial fibrillation (AF) was present in 1 in 6 patients with chronic aortic regurgitation — either moderate-to-severe or severe — and was independently associated with an increased risk for mortality and more severe symptoms. METHODOLOGY: Researchers conducted a retrospective cohort study to determine the prevalence and prognostic significance of AF in patients with hemodynamically significant aortic regurgitation. The study included 1006 patients (mean age, 59 years; 82% men) with moderate-to-severe chronic aortic regurgitation between March 2004 and April 2019. AF was identified using ECG and episodes were recorded by implanted cardiac devices. The primary endpoint was all-cause mortality. Inclusion was halted for patients who received an aortic valve replacement. TAKEAWAY: AF was present in 16% of patients at the time of diagnosis of chronic aortic regurgitation. Those with AF were more likely to be older (adjusted odds ratio [aOR] per year increase, 1.06), men (aOR, 3.55), and have a diagnosis of congestive heart failure (aOR, 2.11; P ≤ .001 for all). AF was independently associated with a significantly elevated risk for mortality in all three multivariable models even after adjusting for comorbid conditions and left ventricular systolic and diastolic function, with hazard ratios ranging from 1.61 to 2.21 (P < .05 for all). Patients with AF had more severe symptoms and a higher risk for death than those with sinus rhythm (P < .05 for both). The median duration between the diagnoses of AF and aortic regurgitation was 2.1 years, and AF was usually paroxysmal. IN PRACTICE: The findings 'highlight the need for a more comprehensive evaluation of cardiac function, including assessment of AF, in patients with chronic, hemodynamically significant [aortic regurgitation] rather than focusing solely' on left ventricle systolic function, the researchers reported. The results also underscore the need for prospective studies 'to validate risk factors for the development of AF in chronic [aortic regurgitation] and to assess whether the onset of AF could aid in risk stratification, including the timing of intervention,' they added. SOURCE: This study was led by Giordano M. Pugliesi, MD, of the University of Milan-Bicocca in Milan, Italy. It was published online on July 16, 2025, in Heart. The findings were previously presented as a poster at the American College of Cardiology (ACC) Scientific Session 2025 in Chicago. LIMITATIONS: The retrospective analysis had incomplete data on comorbidities, cerebral embolic events, hospitalizations for heart failure, and causes of death. Lack of systematic screening may have underestimated the prevalence of AF. This study was conducted at a single tertiary center, potentially introducing referral bias. DISCLOSURES: This study received support through an intramural grant by Mayo Clinic. The authors declared having no competing interests. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

Former All Black Kevin Mealamu joins Creative NZ board, shares health update
Former All Black Kevin Mealamu joins Creative NZ board, shares health update

NZ Herald

time4 days ago

  • Health
  • NZ Herald

Former All Black Kevin Mealamu joins Creative NZ board, shares health update

'I always thought I'd be illustrating a few more children's books, which I've been lucky enough to do. I think even governance, I don't think it's something that many people think about doing. I think I feel really very honoured and blessed and privileged to be able to do it.' Whilst navigating the complex ecosystems of governance, having joined the board of New Zealand Rugby too, Mealamu has also been on the mend after finding out he has a heart condition known as Atrial Fibrillation, which causes an irregular heartbeat. Keven Mealamu (right) with All Blacks teammate Jerome Kaino and the Webb Ellis trophy after winning the Rugby World Cup final in 2015. Photo / Photosport Last year, he shared footage on social media showing him collapsing at a gym. He found out he had the condition after two heavy training bouts in preparation for a charity boxing event in 2022. 'Sometimes when I look back, I think to myself, 'what was I thinking?' But it's probably that mentality of coming out of professional sports, just loving the opportunity to challenge yourself,' Mealamu tells Culture 101. Since then, he's undergone medical procedures and been in and out of hospital to treat it for the past three years. 'I had one done before Christmas and it had been in rhythm. But I found out a couple of weeks ago it's gone back into AFib again. 'I don't have the symptoms where some people find it really hard to walk or [it] just comes on really spontaneously. But I'm able to control mine.' Bringing a lens that connects people Mealamu's ultimate dream to be an All Black was always a clear vision in his head. But he knew he couldn't just sit and wait around – someone had to pay the bills, he says. So while chasing a professional rugby career, he took on an apprenticeship opportunity that came via his school coach: signwriting. To get to his workplace, he remembers he would bike from Māngere to Ōtara, which he considered part of his training as well. 'I can't remember how many times I'd get a flatty and have to be shamefully walking my bike all the way home. So when I had the opportunity to go into rugby, it was probably one of the cool things. I was like, 'yes, I don't have to bike to work anymore'.' Keven Mealamu thanks his supporters after his last game for the Blues at Eden Park, Auckland on June 12, 2015. Photo / Photosport Now he sees how the two fields – art and sport – align in that they can both have an impact on the community. 'You can feel the passion in what both art and sport do. You can feel the passion in who's presenting it,' Mealamu says. 'You look at one of the most influential rugby players around in the world at the moment, Ardie Savea, and just the way he expresses himself and the way he carries himself, there's a strong cultural bit to him as well.' Being at the helm is a big part of who he is, he says, having captained the All Blacks three times and remaining a key part of the leadership group for more than a decade. 'I think what I do bring to the [Creative New Zealand] board is an authentic Pacific Island New Zealander leader. So that lens, I think, is really important. A lens that has been through community all the way to the very top of my sport but also work[s] well with other leaders and community.' But if there's something he's wistful about, it's the fact he didn't join earlier. 'I just wish I was on earlier to be able to share that moment with my Mum, because as proud as I am being able to have both my parents around as I became an All Black, this one also would have been something that she would have been really proud of as well.' – RNZ

Post-Ablation Visual Auras a Sign of Transient Brain Injury?
Post-Ablation Visual Auras a Sign of Transient Brain Injury?

Medscape

time16-07-2025

  • Health
  • Medscape

Post-Ablation Visual Auras a Sign of Transient Brain Injury?

Catheter ablation procedures involving transseptal puncture — typically used to treat atrial fibrillation — are often linked to migraine-like visual auras, though the underlying cause has been unclear. New evidence suggests these auras may stem not from the puncture itself but from acute, procedure-related brain emboli affecting the visual cortex. Gregory Marcus, MD, MAS 'These research findings have two distinct clinically relevant implications,' senior author Gregory Marcus, MD, MAS, cardiac electrophysiologist and endowed professor of atrial fibrillation research, University of California San Francisco (UCSF), told Medscape Medical News . 'First, they suggest that migraine symptoms with visual auras are less likely to be due to shunting of some neuroactive compound across interatrial septal defects and more likely occur as a result of occlusion of blood flow due to brain emboli,' Marcus said. 'Second, these findings demonstrate that, contrary to a long-held belief that these post-ablation MRI-detected small brain lesions are asymptomatic — in fact, they are often referred to as 'asymptomatic cerebral emboli' or 'ACEs' — these small acute brain lesions actually can, and perhaps often do, manifest in clinical symptoms,' he added. 'This finding could change the whole paradigm of treatment, perhaps focusing more on prevention of blood clots,' he added in a statement. The study was published online on July 7 in the journal Heart Rhythm . Brain Injury From Catheter Ablation? The TRAVERSE trial enrolled 146 adults undergoing catheter ablation for ventricular arrhythmias; 74 were randomly allocated to ventricular access via transeptal puncture (creating a new, temporary hole between the left and right atria) and 72 to a retrograde approach (through the aortic valve, not requiring transseptal puncture). All patients underwent high-resolution brain MRI the day after ablation and 63 (85%) in the transseptal group and 57 (79%) in the retrograde group completed a validated migraine questionnaire, a median of 38 days after the procedure. There was no difference in post-ablation visual auras between the transseptal and retrograde aortic approaches (16% and 14%, respectively). However, significantly more patients with acute brain emboli in the occipital or parietal lobes reported migraine-related visual auras (38% vs 11%; P < .01). After multivariable adjustment, the presence of acute brain emboli in the occipital or parietal lobes was associated with a 12-fold greater likelihood of visual auras. The data show that these post-ablation brain lesions are not 'clinically silent,' first author Adi Elias, MD, cardiac electrophysiology fellow at UCSF, noted in the statement. 'It may be the case that we haven't known what to look for and assessed for symptoms immediately without enough time for the subsequent visual auras that would occur,' Elias said. Marcus elaborated on this point. He noted that prior studies have demonstrated that these small post-catheter ablation MRI-detected lesions can no longer be detected upon repeat imaging about a month later, demonstrating that the ability to detect these brain emboli is fleeting. 'Prior studies failed to demonstrate a relationship between migraine with visual aura and acute brain emboli, but perhaps they were too late to detect ephemeral MRI findings because the MRI had to be ordered and performed after symptoms develop,' Marcus said. The TRAVERSE study is 'unique in that everyone had a brain MRI immediately after their catheter ablation procedure and likely in most, if not all cases, prior to the development of their visual aura symptoms,' he noted. Importantly, said the researchers, the presence of brain emboli and visual auras was not associated with any significant change in cognition. Marcus said patients can be reassured that procedure-related brain emboli and visual auras typically fade within a month of the procedure. An Under-Recognized Condition Reached for comment, Mina Chung, MD, president of the Heart Rhythm Society, who wasn't involved in the study, told Medscape Medical News the occurrence of visual auras after ablation may be 'under-recognized.' The fact that a prior history of visual auras was associated with visual auras at 1 month after the procedure, 'suggests some preexisting tendency toward such symptoms after these procedures,' said Chung, with the Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland. 'Reassuringly, there were no detectable differences in neurocognitive function,' said Chung.

Boston Scientific's (BSX) FARAPULSE Approved by FDA for Expanded Labeling
Boston Scientific's (BSX) FARAPULSE Approved by FDA for Expanded Labeling

Yahoo

time14-07-2025

  • Business
  • Yahoo

Boston Scientific's (BSX) FARAPULSE Approved by FDA for Expanded Labeling

Boston Scientific Corporation (NYSE:BSX) is one of the 13 Best Large Cap Stocks to Buy Right Now. On July 7, Boston Scientific Corporation (NYSE:BSX) announced that it has obtained approval to expand the instructions for use (IFU) labeling for the FARAPULSE Pulsed Field Ablation (PFA) System from the US Food and Drug Administration (FDA). The new labeling will allow the system to be used in the treatment of drug-refractory, symptomatic persistent atrial fibrillation (AF), a condition where the heart beats abnormally for a minimum of seven days. A surgeon examining a patient's brain in an operating room, paramedics nearby. Boston Scientific Corporation (NYSE:BSX) expects to receive approval in Europe, Japan, and China in the coming months. This will make the system available to more patients around the world in the near future. Boston Scientific Corporation (NYSE:BSX) is an American biotechnology and biomedical engineering firm that offers a portfolio of devices and therapies that help physicians diagnose and treat cardiovascular, respiratory, digestive, oncological, neurological, and urological diseases and conditions. While we acknowledge the potential of BSX as an investment, we believe certain AI stocks offer greater upside potential and carry less downside risk. If you're looking for an extremely undervalued AI stock that also stands to benefit significantly from Trump-era tariffs and the onshoring trend, see our free report on the best short-term AI stock. READ NEXT: 10 Best American Semiconductor Stocks to Buy Now and 11 Best Fintech Stocks to Buy Right Now. Disclosure: None. This article is originally published at Insider Monkey. Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data

Boston Scientific's (BSX) FARAPULSE Approved by FDA for Expanded Labeling
Boston Scientific's (BSX) FARAPULSE Approved by FDA for Expanded Labeling

Yahoo

time13-07-2025

  • Business
  • Yahoo

Boston Scientific's (BSX) FARAPULSE Approved by FDA for Expanded Labeling

Boston Scientific Corporation (NYSE:BSX) is one of the 13 Best Large Cap Stocks to Buy Right Now. On July 7, Boston Scientific Corporation (NYSE:BSX) announced that it has obtained approval to expand the instructions for use (IFU) labeling for the FARAPULSE Pulsed Field Ablation (PFA) System from the US Food and Drug Administration (FDA). The new labeling will allow the system to be used in the treatment of drug-refractory, symptomatic persistent atrial fibrillation (AF), a condition where the heart beats abnormally for a minimum of seven days. A surgeon examining a patient's brain in an operating room, paramedics nearby. Boston Scientific Corporation (NYSE:BSX) expects to receive approval in Europe, Japan, and China in the coming months. This will make the system available to more patients around the world in the near future. Boston Scientific Corporation (NYSE:BSX) is an American biotechnology and biomedical engineering firm that offers a portfolio of devices and therapies that help physicians diagnose and treat cardiovascular, respiratory, digestive, oncological, neurological, and urological diseases and conditions. While we acknowledge the potential of BSX as an investment, we believe certain AI stocks offer greater upside potential and carry less downside risk. If you're looking for an extremely undervalued AI stock that also stands to benefit significantly from Trump-era tariffs and the onshoring trend, see our free report on the best short-term AI stock. READ NEXT: 10 Best American Semiconductor Stocks to Buy Now and 11 Best Fintech Stocks to Buy Right Now. Disclosure: None. This article is originally published at Insider Monkey. Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data

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